ADULT APPLICATION BOY SCOUTS OF AMERICA
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BOY SCOUTS OF AMERICA
ADULT APPLICATION This application is also available in Spanish. Esta solicitud también está disponible en español.
The mission of the Boy Scouts
of America is to prepare young
people to make ethical and
moral choices over their lifetimes
by instilling in them the values
of the Scout Oath and Scout Law.
In a Cub Scout pack, Boy Scout troop, Varsity Scout team, Venturing crew, or Sea Scout ship—or in any position in a district or
council—your participation in the Boy Scouts of America can help youth become better citizens.
High-quality adults are important role models for youth in the Boy Scouts of America. This application helps the chartered
organization select qualified adults. Thank you for completing this application in full. See instructions on the inside cover.
BY SUBMITTING THIS APPLICATION YOU ARE AUTHORIZING Youth Protection Training
A CRIMINAL BACKGROUND CHECK OF YOURSELF. All applicants for membership are required to take this
training within 30 days of registering. To take it online, go
THIS CHECK WILL BE MADE FROM PUBLIC RECORD SOURCES. to www.MyScouting.org and establish an account using the
YOU WILL HAVE AN OPPORTUNITY TO member number you receive when you register. If you take
the training online before you obtain a member number, be
REVIEW AND CHALLENGE ANY ADVERSE sure to return to MyScouting and enter your number for
INFORMATION DISCLOSED BY THE CHECK. training record credit. Your BSA local council also provides
training on a regular basis if you cannot take it online.
IF YOU WOULD LIKE A COPY OF YOUR CRIMINAL BACKGROUND
REPORT, PLEASE CONTACT YOUR LOCAL COUNCIL OFFICE. For more information, refer to the back of this application.
524-501115Purpose of the Boy Scouts of America member, but it is absolutely nonsectarian in its attitude toward that religious training. Its policy is that
The purpose of the Boy Scouts of America is to promote, through cooperation with other agencies, the home and organization or group with which the member is connected shall give definite attention
the ability of youth to do things for themselves and others, and to teach youth patriotism, courage, to religious life. Only persons willing to subscribe to these precepts from the Declaration of Religious
self-reliance, and kindred virtues. In achieving this purpose, emphasis is placed upon the Boy Scouts Principle and to the Bylaws of the Boy Scouts of America shall be entitled to register.
of America’s educational program and its oaths, promises, and codes for character development,
citizenship training, and mental and physical fitness.
Leadership Requirements
The applicant must possess the moral, educational, and emotional qualities that the Boy Scouts of
Excerpt From Declaration of Religious Principle America deems necessary to afford positive leadership to youth. The applicant must also be the correct
The Boy Scouts of America maintains that no member can grow into the best kind of citizen without age, subscribe to the precepts of the Declaration of Religious Principle, and abide by the Scout Oath or
recognizing an obligation to God and, therefore, recognizes the religious element in the training of the Promise, and the Scout Law.
APPROVAL REQUIRED—UNIT ADULTS committee chairman, all other unit adults must be approved by the head of the chartered
Unit committee chairman approves all unit adults except the chartered organization representative and organization or the chartered organization representative.
committee chairman. Scout executive or designee must approve all unit adults who answered “yes” to Additional Information questions.
Chartered organization head or chartered organization representative. The chartered organization APPROVAL REQUIRED—COUNCIL and DISTRICT ADULTS
representative is approved by the head of the chartered organization. Following approval by the unit Scout executive or designee must approve all council and district adults.
Scouting magazine. This magazine is sent to all registered, paid adults. UNIT POSITION CODES
FEE CHART*
Boys’ Life. Registered adults get a special rate of $12 a year (half the regular rate of $24 a year). For a subscription to a great CR Chartered organization representative
Months Registration Boys’ CC Committee chairman
magazine and up-to-date information on boys and Scouting, just attach the appropriate amount and fill in the Boys’ Life circle.
Please calculate and remit the appropriate state and local taxes. On late registrations it may be necessary to deliver back issues. Life MC Committee member
1 2.00 — SM Scoutmaster
Qualification. Adult citizens, or adult noncitizens who reside within the country, may register with the Boy Scouts of America in any SA Assistant Scoutmaster
capacity if they agree to abide by the Scout Oath or Promise and the Scout Law, to respect and obey the laws of the United States of 2 4.00 2.00 92U Unit College Scouter Reserve
America, and to subscribe to the precepts of the Declaration of Religious Principle. All leaders must be 21 years of age or older, except 91U Unit Scouter Reserve
College Scouter Reserve, assistant Scoutmasters, assistant den leaders, assistant Cubmasters, assistant Webelos den leaders, and 3 6.00 3.00 NL Crew Advisor
assistant Varsity Scout coaches, who must be 18 or older. No one may register in more than one position in the same unit, except the NA Crew associate Advisor
chartered organization representative (CR) (who can multiple only as the committee chairman (CC) or a committee member (MC)), and 4 8.00 4.00 SK Skipper
the parent coordinator (PC), who may multiple as chartered organization representative. 5 10.00 5.00 MT Mate
Youth Protection. Child abuse is a serious problem in our society, and unfortunately, it can occur anywhere, even in Scouting. Youth VC Varsity Scout Coach
safety is of paramount importance to Scouting. For that reason, the BSA continues to create barriers to abuse beyond what have previ- 6 12.00 6.00 VA Assistant Varsity Scout Coach
CM Cubmaster
ously existed in Scouting.
7 14.00 7.00 CA Assistant Cubmaster
All persons involved in Scouting shall report to local authorities any good-faith suspicion or belief that any child is or has been physically WL Webelos den leader
or sexually abused, physically or emotionally neglected, exposed to any form of violence or threat, exposed to any form of sexual exploi- 8 16.00 8.00 WA Assistant Webelos den leader
tation including the possession, manufacture, or distribution of child pornography; online solicitation; enticement; or showing of obscene DL Den leader
material. No person may abdicate this reporting responsibility to any other person. 9 18.00 9.00 DA Assistant den leader
Notify your Scout executive of this report, or of any violation of the BSA’s Youth Protection policies, so that he or she may take appropri- TL Tiger den leader
10 20.00 10.00
ate action for the safety of our Scouts, make appropriate notifications, and follow up with investigating agencies. PT Pack trainer
11 22.00 11.00 PC Parent coordinator
Ethnic Background Information. Please fill in the appropriate circle on the application to indicate ethnic background. 10 Leader of 11-year old Scouts (LDS Troop)
BSA Privacy Policy. The Boy Scouts of America protects the confidentiality of the names and personal information of those who 12 24.00 12.00 88 Lone Cub Scout friend and counselor
are affiliated with the organization. No commercial or unauthorized use is made of the names, addresses, and other confidential 96 Lone Scout friend and counselor
information. Access to this information is strictly limited. * National registration fees are nonrefundable. Tiger adult partners (AP) complete the bottom
portion of the youth application.
This application is designed to be an information-gathering aid. Answers given by the applicant may be verified.
INSTRUCTIONS Tips for completing the Application for Adult Membership:
Unit Adults (Use blue or black ink)
1. Complete and sign the top copy. Keep the back copy (applicant copy) and give the remaining copies to the committee ➢Print—do not use cursive.
chairman with the proper fees. ➢Use black or dark blue ink.
2. After the application has been reviewed and, if necessary, references checked by the unit committee, secure the approvals. ➢Press firmly when printing.
The process set forth in the publication Selecting Quality Leaders, No. 522-981, must be completed for all positions of ➢Print one letter only in each box.
Scoutmaster, assistant Scoutmaster, Varsity Coach, and assistant Varsity Coach.
3. The committee chairman keeps the unit copy, gives one copy to the chartered organization, and forwards the remaining ➢Use uppercase letters and stay within the blue boxes for legibility.
copy to the local council service center for approval and processing. ➢Fill in circles; do not use check marks.
Council and District Adults ➢Make sure you have all needed signatures on application.
1. Complete and sign the application. ➢Don’t alter the application—it could affect the quality of the scan.
2. Send the proper fee and all three copies of the application to the local council service center for approval and processing. Mailing address example:
7 0 3 F I R S T S TInstructions: Please read the Disclosure/Authorization Form on the back of this page. In the space provided at the bottom of the statement, fill in the spaces for your name, signature, and date to acknowledge your review of the form. This Disclosure/Authorization Form and the Boy Scouts of America Adult Application must be signed and turned in together to complete the application process.
DISCLOSURE/AUTHORIZATION FORM
NOTICE TO APPLICANT REGARDING BACKGROUND CHECK ADDITIONAL NOTICES TO CALIFORNIA, MINNESOTA, OKLAHOMA,
AND NEW YORK APPLICANTS
In order to safeguard the youth in our program, the Boy Scouts of America will procure consumer
reports on you in connection with your application, and the Boy Scouts of America may procure California
additional consumer reports at any time in order to evaluate your continued suitability for
Under California law, the consumer reports described above that the Boy Scouts of America will procure
participation. The Boy Scouts of America has contracted with First Advantage, a consumer reporting
on you are defined as investigative consumer reports. These reports will be procured in connection with
agency, to provide the consumer reports. First Advantage may be contacted by mail at First
your application, and additional reports may be procured at any time during your service as a volunteer in
Advantage, 1000 Alderman Drive, Alpharetta, GA 30005 or by telephone at 800-845-6004.
order to evaluate your continued suitability for participation. The reports may include information on your
The consumer reports may contain information bearing on your character, general reputation, character, general reputation, personal characteristics, and mode of living.
personal characteristics, and mode of living. The types of information that may be obtained include
Under section 1786.22 of the California Civil Code, you may inspect the file maintained on you by First
but are not limited to Social Security number verification, sex offender registry checks, criminal
Advantage, during normal business hours and with proper identification. You may also obtain a copy of
records checks, inmate records searches, and court records checks. The information contained
this file, upon submitting proper identification and paying the costs of duplication, by appearing at First
in these consumer reports may be obtained by First Advantage from public record sources. The
Advantage offices in person, during normal business hours and on reasonable notice, or by certified mail
consumer reports will not include credit record checks or motor vehicle record checks.
upon making a written request. You may also receive a summary of the information contained in this file
The nature and scope of the consumer reports are described above. Nonetheless, you are by telephone. First Advantage will provide trained personnel to explain any information furnished to you
entitled to request a complete and accurate disclosure of the nature and scope of such reports and will provide a written explanation of any coded information. This written explanation will be provided
by submitting a written request to First Advantage at the address listed above. Additional notices whenever a file is provided to you for visual inspection. If you appear in person, you may be accompanied
for applicants in California, New York, Minnesota, and Oklahoma are provided. by one other person of your choosing, who must furnish reasonable identification.
APPLICANT’S ACKNOWLEDGMENT AND AUTHORIZATION For Applicants in California, Minnesota, and Oklahoma Only
I have carefully read this notice and authorization form and I hereby authorize the Boy Scouts of You have the right to request a free copy of any report procured on you. If you wish to receive a free
America and First Advantage to procure a consumer report, which as described above will include copy of any report procured on you, check the box below.
information relating to my criminal history as received from reporting agencies. I understand
I request a free copy of any report procured on me.
that this information will be used to determine my eligibility in the Boy Scouts of America. I also
understand that additional consumer reports may be procured at any time. I understand that if the New York
Boy Scouts of America chooses not to accept my application or to revoke my membership based
As explained above, a consumer report will be requested in connection with your application, and
on information contained in a consumer report, I will receive a summary of my rights under the Fair
additional consumer reports may be requested during the course of your participation with the Boy Scouts
Credit Reporting Act and contact information for the reporting agency, First Advantage.
of America. You have the right, upon request, to be informed whether or not a consumer report was
requested and, if a consumer report was requested, of the name and address of the consumer reporting
agency that furnished the consumer report.
My signature below indicates that I have read, understand, and accept the accompanying disclosures and acknowledgments.
First name (No initials or nicknames) Please print. Middle name Last name Suffix
Retain in permanent file.
Signature of applicant Date Unit No.ADULT APPLICATION 524-501 This form is read by machine. Please print the numbers and letters as shown: 1 2 3 4 5 6 7 8 9 0 A B C D E F G H I
UNIT ADULTS (Fill in the circle.) Council/district position code All questions must be answered. Write NONE if applicable.
1. Scouting background.
The information obtained in this form is for the Pack Troop Team Crew Ship Unit Position Council Year
internal use of the BSA only. No. OR _____________________________________
District name _____________________________________
_____________________________________
EXPIRE DATE / / TERM MONTHS New leader Former leader Venturer 2. Experience working with youth in other
organizations. Please provide contact information.
_____________________________________
If applicant has an unexpired membership certificate, registration may be accomplished at no charge by transferring the registration. Mark and attach a copy of the certificate. _____________________________________
3. Previous residences (for last five years).
TRANSFER FROM: COUNCIL NO. TYPE OF UNIT UNIT NO. City State
________________________ _____________
________________________ _____________
Please print one letter in each space—press hard; you are making three copies.
4. Current memberships (religious, community,
First name (No initials or nicknames) Middle name Last name Suffix business, labor, or professional organizations).
_____________________________________
_____________________________________
5. References. Please list those who are familiar with
Have you completed: Youth Protection training Fast Start training your character. References may be checked.
Name___________________________________
Country Mailing address City State Zip code Telephone (_____)__________________________
Name___________________________________
US Telephone (_____)__________________________
Name___________________________________
Home phone Business phone Ext. Cell phone Telephone (_____)__________________________
6. Additional information. Yes No
- - - - X - - (Mark each answer.)
Date of birth (mm/dd/yyyy) Ethnic background: Driver’s license No. State
a. Have you ever been removed from
or asked to leave a leadership
Black/African American Native American Alaska Native Asian position in an organization due to
allegations regarding your personal
/ /
Caucasian/White Hispanic/Latino Pacific Islander Other conduct or behavior? Explain:
_____________________________________
Gender Social Security No. (required) Occupation Employer _____________________________________
_____________________________________
M F - - b. Do you use illegal drugs or abuse
alcohol? Explain:
Country Business address City State Zip code _____________________________________
_____________________________________
US _____________________________________
c. Have you ever been arrested for a
criminal offense (other than minor
Position Code Scouting position (description) Are you an Eagle Scout? Date earned (mm/dd/yyyy) traffic violations)? Explain:
_____________________________________
Yes No / / _____________________________________
_____________________________________
E-mail address Work Boys’ Life
d. Has your driver’s license ever been
(Select one) Home
@ subscription
suspended or revoked? Explain:
_____________________________________
_____________________________________
I understand that: APPROVALS FOR UNIT ADULTS: I have reviewed this application and the responses to any questions answered “Yes” _____________________________________
1. By submitting this application I am authorizing the Boy Scouts of America to obtain a background check using First Advantage, INITIALS with the applicant or source listed. I believe the applicant possesses the moral, educational, and emotional qualities of an
1000 Alderman Drive, Alpharetta, GA 30005, and understand it will be used in determining my eligibility. I have reviewed and REQUIRED adult in the Boy Scouts of America. e. Have you ever been investigated for,
accused of, or charged with abuse or
agreed to the terms and conditions regarding this check and your rights with respect to reviewing or obtaining copies of any _________
information provided. neglect of a minor child? Explain:
2. I agree to complete Youth Protection training within 30 days of this application and abide by the youth protection requirements INITIALS Signature of unit committee chairman Date _____________________________________
of the Boy Scouts of America (www.MyScouting.org). REQUIRED I have reviewed this application and the responses to any questions answered “Yes” and the comments made by the _____________________________________
_________ unit leader approving the application. Neither I nor the religious or organizational leader of our organization is aware of _____________________________________
any information indicating that the applicant does not possess the moral, educational, and emotional qualities of an adult
3. I hereby release and agree to hold harmless from liability any person or organization; local council; chartered organization;
and the Boy Scouts of America and its officers, directors, employees, and volunteers for any injury or damage sustained in
INITIALS
REQUIRED in the Boy Scouts of America. f. Are you aware of any reason
not listed above that may call
connection with my participation. _________
into question your suitability to
4. I have read and affirm that I accept the Declaration of Religious Principle and qualifications for adult participation. I agree to comply INITIALS Signature of chartered organization head or representative Date supervise, guide, care for, and lead
with the rules and regulations of the Boy Scouts of America and the local council. I affirm that the information in this application is REQUIRED
true and correct to the best of my knowledge and belief. APPROVAL FOR COUNCIL AND DISTRICT ADULTS: I have reviewed this application and have made any follow-up inquiries young people?
_________ necessary to be satisfied that the applicant possesses the moral, educational, and emotional qualities of an adult in the _____________________________________
Boy Scouts of America. _____________________________________
_____________________________________
Signature of applicant Date
Signature of Scout executive or designee Date
LOCAL COUNCIL COPY
4001 Registration fee
$ . Boys’ Life fee $ . Retain on file for three years.ADULT APPLICATION 524-501
UNIT ADULTS (Fill in the circle.) Council/district position code All questions must be answered. Write NONE if applicable.
1. Scouting background.
The information obtained in this form is for the Pack Troop Team Crew Ship Unit Position Council Year
internal use of the BSA only. No. OR _____________________________________
District name _____________________________________
_____________________________________
EXPIRE DATE / / TERM MONTHS New leader Former leader Venturer 2. Experience working with youth in other
organizations. Please provide contact information.
_____________________________________
If applicant has an unexpired membership certificate, registration may be accomplished at no charge by transferring the registration. Mark and attach a copy of the certificate. _____________________________________
3. Previous residences (for last five years).
TRANSFER FROM: COUNCIL NO. TYPE OF UNIT UNIT NO. City State
________________________ _____________
________________________ _____________
Please print one letter in each space—press hard; you are making three copies.
4. Current memberships (religious, community,
First name (No initials or nicknames) Middle name Last name Suffix business, labor, or professional organizations).
_____________________________________
_____________________________________
5. References. Please list those who are familiar with
Have you completed: Youth Protection training Fast Start training your character. References may be checked.
Name___________________________________
Country Mailing address City State Zip code Telephone (_____)__________________________
Name___________________________________
US Telephone (_____)__________________________
Name___________________________________
Home phone Business phone Ext. Cell phone Telephone (_____)__________________________
6. Additional information. Yes No
- - - - X - - (Mark each answer.)
Date of birth (mm/dd/yyyy) Ethnic background: Driver’s license No. State
a. Have you ever been removed from
or asked to leave a leadership
Black/African American Native American Alaska Native Asian position in an organization due to
allegations regarding your personal
/ /
Caucasian/White Hispanic/Latino Pacific Islander Other conduct or behavior? Explain:
_____________________________________
Gender Social Security No. (required) Occupation Employer _____________________________________
_____________________________________
M F - - b. Do you use illegal drugs or abuse
alcohol? Explain:
Country Business address City State Zip code _____________________________________
_____________________________________
US _____________________________________
c. Have you ever been arrested for a
criminal offense (other than minor
Position Code Scouting position (description) Are you an Eagle Scout? Date earned (mm/dd/yyyy) traffic violations)? Explain:
_____________________________________
Yes No / / _____________________________________
_____________________________________
E-mail address Work Boys’ Life
d. Has your driver’s license ever been
(Select one) Home
@ subscription
suspended or revoked? Explain:
_____________________________________
_____________________________________
I understand that: APPROVALS FOR UNIT ADULTS: I have reviewed this application and the responses to any questions answered “Yes” _____________________________________
1. By submitting this application I am authorizing the Boy Scouts of America to obtain a background check using First Advantage, INITIALS with the applicant or source listed. I believe the applicant possesses the moral, educational, and emotional qualities of an
1000 Alderman Drive, Alpharetta, GA 30005, and understand it will be used in determining my eligibility. I have reviewed and REQUIRED adult in the Boy Scouts of America. e. Have you ever been investigated for,
accused of, or charged with abuse or
agreed to the terms and conditions regarding this check and your rights with respect to reviewing or obtaining copies of any _________
information provided. neglect of a minor child? Explain:
2. I agree to complete Youth Protection training within 30 days of this application and abide by the youth protection requirements INITIALS Signature of unit committee chairman Date _____________________________________
of the Boy Scouts of America (www.MyScouting.org). REQUIRED I have reviewed this application and the responses to any questions answered “Yes” and the comments made by the _____________________________________
_________ unit leader approving the application. Neither I nor the religious or organizational leader of our organization is aware of _____________________________________
any information indicating that the applicant does not possess the moral, educational, and emotional qualities of an adult
3. I hereby release and agree to hold harmless from liability any person or organization; local council; chartered organization;
and the Boy Scouts of America and its officers, directors, employees, and volunteers for any injury or damage sustained in
INITIALS
REQUIRED in the Boy Scouts of America. f. Are you aware of any reason
not listed above that may call
connection with my participation. _________
into question your suitability to
4. I have read and affirm that I accept the Declaration of Religious Principle and qualifications for adult participation. I agree to comply INITIALS Signature of chartered organization head or representative Date supervise, guide, care for, and lead
with the rules and regulations of the Boy Scouts of America and the local council. I affirm that the information in this application is REQUIRED
true and correct to the best of my knowledge and belief. APPROVAL FOR COUNCIL AND DISTRICT ADULTS: I have reviewed this application and have made any follow-up inquiries young people?
_________ necessary to be satisfied that the applicant possesses the moral, educational, and emotional qualities of an adult in the _____________________________________
Boy Scouts of America. _____________________________________
_____________________________________
Signature of applicant Date
Signature of Scout executive or designee Date
CHARTERED ORGANIZATION COPY
Registration fee
$ . Boys’ Life fee $ . Retain on file for three years.ADULT APPLICATION 524-501
UNIT ADULTS (Fill in the circle.) Council/district position code All questions must be answered. Write NONE if applicable.
1. Scouting background.
The information obtained in this form is for the Pack Troop Team Crew Ship Unit Position Council Year
internal use of the BSA only. No. OR _____________________________________
District name _____________________________________
_____________________________________
EXPIRE DATE / / TERM MONTHS New leader Former leader Venturer 2. Experience working with youth in other
organizations. Please provide contact information.
_____________________________________
If applicant has an unexpired membership certificate, registration may be accomplished at no charge by transferring the registration. Mark and attach a copy of the certificate. _____________________________________
3. Previous residences (for last five years).
TRANSFER FROM: COUNCIL NO. TYPE OF UNIT UNIT NO. City State
________________________ _____________
________________________ _____________
Please print one letter in each space—press hard; you are making three copies.
4. Current memberships (religious, community,
First name (No initials or nicknames) Middle name Last name Suffix business, labor, or professional organizations).
_____________________________________
_____________________________________
5. References. Please list those who are familiar with
Have you completed: Youth Protection training Fast Start training your character. References may be checked.
Name___________________________________
Country Mailing address City State Zip code Telephone (_____)__________________________
Name___________________________________
US Telephone (_____)__________________________
Name___________________________________
Home phone Business phone Ext. Cell phone Telephone (_____)__________________________
6. Additional information. Yes No
- - - - X - - (Mark each answer.)
Date of birth (mm/dd/yyyy) Ethnic background: Driver’s license No. State
a. Have you ever been removed from
or asked to leave a leadership
Black/African American Native American Alaska Native Asian position in an organization due to
allegations regarding your personal
/ /
Caucasian/White Hispanic/Latino Pacific Islander Other conduct or behavior? Explain:
_____________________________________
Gender Social Security No. (required) Occupation Employer _____________________________________
_____________________________________
M F - - b. Do you use illegal drugs or abuse
alcohol? Explain:
Country Business address City State Zip code _____________________________________
_____________________________________
US _____________________________________
c. Have you ever been arrested for a
criminal offense (other than minor
Position Code Scouting position (description) Are you an Eagle Scout? Date earned (mm/dd/yyyy) traffic violations)? Explain:
_____________________________________
Yes No / / _____________________________________
_____________________________________
E-mail address Work Boys’ Life
d. Has your driver’s license ever been
(Select one) Home
@ subscription
suspended or revoked? Explain:
_____________________________________
_____________________________________
I understand that: APPROVALS FOR UNIT ADULTS: I have reviewed this application and the responses to any questions answered “Yes” _____________________________________
1. By submitting this application I am authorizing the Boy Scouts of America to obtain a background check using First Advantage, INITIALS with the applicant or source listed. I believe the applicant possesses the moral, educational, and emotional qualities of an
1000 Alderman Drive, Alpharetta, GA 30005, and understand it will be used in determining my eligibility. I have reviewed and REQUIRED adult in the Boy Scouts of America. e. Have you ever been investigated for,
accused of, or charged with abuse or
agreed to the terms and conditions regarding this check and your rights with respect to reviewing or obtaining copies of any _________
information provided. neglect of a minor child? Explain:
2. I agree to complete Youth Protection training within 30 days of this application and abide by the youth protection requirements INITIALS Signature of unit committee chairman Date _____________________________________
of the Boy Scouts of America (www.MyScouting.org). REQUIRED I have reviewed this application and the responses to any questions answered “Yes” and the comments made by the _____________________________________
_________ unit leader approving the application. Neither I nor the religious or organizational leader of our organization is aware of _____________________________________
any information indicating that the applicant does not possess the moral, educational, and emotional qualities of an adult
3. I hereby release and agree to hold harmless from liability any person or organization; local council; chartered organization;
and the Boy Scouts of America and its officers, directors, employees, and volunteers for any injury or damage sustained in
INITIALS
REQUIRED in the Boy Scouts of America. f. Are you aware of any reason
not listed above that may call
connection with my participation. _________
into question your suitability to
4. I have read and affirm that I accept the Declaration of Religious Principle and qualifications for adult participation. I agree to comply INITIALS Signature of chartered organization head or representative Date supervise, guide, care for, and lead
with the rules and regulations of the Boy Scouts of America and the local council. I affirm that the information in this application is REQUIRED
true and correct to the best of my knowledge and belief. APPROVAL FOR COUNCIL AND DISTRICT ADULTS: I have reviewed this application and have made any follow-up inquiries young people?
_________ necessary to be satisfied that the applicant possesses the moral, educational, and emotional qualities of an adult in the _____________________________________
Boy Scouts of America. _____________________________________
_____________________________________
Signature of applicant Date
Signature of Scout executive or designee Date
UNIT COPY
Registration fee
$ . Boys’ Life fee $ . Retain on file for three years.ADULT APPLICATION 524-501
UNIT ADULTS (Fill in the circle.) Council/district position code All questions must be answered. Write NONE if applicable.
1. Scouting background.
The information obtained in this form is for the Pack Troop Team Crew Ship Unit Position Council Year
internal use of the BSA only. No. OR _____________________________________
District name _____________________________________
_____________________________________
EXPIRE DATE / / TERM MONTHS New leader Former leader Venturer 2. Experience working with youth in other
organizations. Please provide contact information.
_____________________________________
If applicant has an unexpired membership certificate, registration may be accomplished at no charge by transferring the registration. Mark and attach a copy of the certificate. _____________________________________
3. Previous residences (for last five years).
TRANSFER FROM: COUNCIL NO. TYPE OF UNIT UNIT NO. City State
________________________ _____________
________________________ _____________
Please print one letter in each space—press hard; you are making three copies.
4. Current memberships (religious, community,
First name (No initials or nicknames) Middle name Last name Suffix business, labor, or professional organizations).
_____________________________________
_____________________________________
5. References. Please list those who are familiar with
Have you completed: Youth Protection training Fast Start training your character. References may be checked.
Name___________________________________
Country Mailing address City State Zip code Telephone (_____)__________________________
Name___________________________________
US Telephone (_____)__________________________
Name___________________________________
Home phone Business phone Ext. Cell phone Telephone (_____)__________________________
6. Additional information. Yes No
- - - - X - - (Mark each answer.)
Date of birth (mm/dd/yyyy) Ethnic background: Driver’s license No. State
a. Have you ever been removed from
or asked to leave a leadership
Black/African American Native American Alaska Native Asian position in an organization due to
allegations regarding your personal
/ /
Caucasian/White Hispanic/Latino Pacific Islander Other conduct or behavior? Explain:
_____________________________________
Gender Social Security No. (required) Occupation Employer _____________________________________
_____________________________________
M F - - b. Do you use illegal drugs or abuse
alcohol? Explain:
Country Business address City State Zip code _____________________________________
_____________________________________
US _____________________________________
c. Have you ever been arrested for a
criminal offense (other than minor
Position Code Scouting position (description) Are you an Eagle Scout? Date earned (mm/dd/yyyy) traffic violations)? Explain:
_____________________________________
Yes No / / _____________________________________
_____________________________________
E-mail address Work Boys’ Life
d. Has your driver’s license ever been
(Select one) Home
@ subscription
suspended or revoked? Explain:
_____________________________________
_____________________________________
I understand that: APPROVALS FOR UNIT ADULTS: I have reviewed this application and the responses to any questions answered “Yes” _____________________________________
1. By submitting this application I am authorizing the Boy Scouts of America to obtain a background check using First Advantage, INITIALS with the applicant or source listed. I believe the applicant possesses the moral, educational, and emotional qualities of an
1000 Alderman Drive, Alpharetta, GA 30005, and understand it will be used in determining my eligibility. I have reviewed and REQUIRED adult in the Boy Scouts of America. e. Have you ever been investigated for,
accused of, or charged with abuse or
agreed to the terms and conditions regarding this check and your rights with respect to reviewing or obtaining copies of any _________
information provided. neglect of a minor child? Explain:
2. I agree to complete Youth Protection training within 30 days of this application and abide by the youth protection requirements INITIALS Signature of unit committee chairman Date _____________________________________
of the Boy Scouts of America (www.MyScouting.org). REQUIRED I have reviewed this application and the responses to any questions answered “Yes” and the comments made by the _____________________________________
_________ unit leader approving the application. Neither I nor the religious or organizational leader of our organization is aware of _____________________________________
any information indicating that the applicant does not possess the moral, educational, and emotional qualities of an adult
3. I hereby release and agree to hold harmless from liability any person or organization; local council; chartered organization;
and the Boy Scouts of America and its officers, directors, employees, and volunteers for any injury or damage sustained in
INITIALS
REQUIRED in the Boy Scouts of America. f. Are you aware of any reason
not listed above that may call
connection with my participation. _________
into question your suitability to
4. I have read and affirm that I accept the Declaration of Religious Principle and qualifications for adult participation. I agree to comply INITIALS Signature of chartered organization head or representative Date supervise, guide, care for, and lead
with the rules and regulations of the Boy Scouts of America and the local council. I affirm that the information in this application is REQUIRED
true and correct to the best of my knowledge and belief. APPROVAL FOR COUNCIL AND DISTRICT ADULTS: I have reviewed this application and have made any follow-up inquiries young people?
_________ necessary to be satisfied that the applicant possesses the moral, educational, and emotional qualities of an adult in the _____________________________________
Boy Scouts of America. _____________________________________
_____________________________________
Signature of applicant Date
Signature of Scout executive or designee Date
APPLICANT COPY
Registration fee
$ . Boys’ Life fee $ . Retain on file for three years.Training for New Volunteers
Every Youth in Scouting Deserves a Trained Leader
Welcome to Scouting! As a new Scout volunteer, you are joining our Scouting family, and we want you to understand how the program works. The Boy Scouts of America is committed to your success
as a volunteer while serving young people. To help you be successful there are training materials designed for you.
So, How Do I Begin? Online or Through Your Council Service Center
Training for Cub Scout, Boy Scout, Varsity, and Venturing leaders as well as Youth Protection training programs are available at www.MyScouting.org. Additional training opportunities and resources are avail-
able through your local council and www.scouting.org/training.
All applicants for membership are required to complete Youth Protection training within 30 days of registering.
What Makes a Trained Leader? (Check when completed)
Cub Scout leaders are considered trained when they have completed Youth Protection training* and Cub Scout Leader Position-Specific Training* (for their position).
Scoutmasters and assistant Scoutmasters are considered trained when they have completed Youth Protection training*, Scoutmaster and Assistant Scoutmaster Leader Specific Training,
and Introduction to Outdoor Leader Skills.
Troop committee members are considered trained when they have completed Youth Protection training* and the Troop Committee Challenge*.
Varsity Scout leaders and assistants are considered trained when they have completed Youth Protection training*, Varsity Scout Leader Specific Training, and Introduction to Outdoor Leader Skills.
Team committee members are considered trained when they have completed Youth Protection training* and Team Committee Challenge.
Venturing crew Advisors and assistant Advisors are considered trained when they have completed Youth Protection training*, Venturing version*, and Venturing Leader Specific Training.
Crew committee members are considered trained when they have completed Youth Protection training*, Venturing version*, and Crew Committee Challenge.
What Is Youth Protection Training?
We seek to create as safe an environment as possible for young people to enjoy our program’s activities. The Boy Scouts of America Youth Protection training addresses strategies for personal safety
awareness for youth as well as adults. Age-appropriate programs and DVD materials include:
• Youth Protection Guidelines: Training for Volunteer Leaders and Parents—Adults come away with a much clearer awareness of the kinds of abuse, the signs of abuse, and how to respond and
report should a situation arise. Youth Protection training must be taken every two years.
• Youth Protection Guidelines: Training for Adult Venturing Leaders—Designed to give guidance to the leaders in our teenage coed Venturing program. Supervision and relationship issues have a
different focus regarding personal safety with this age group. Youth Protection training must be taken every two years.
• It Happened to Me—Developed for Cub Scout–age boys from 6 to 10 years old and their parents. It addresses the four rules of personal safety: Check first, go with a friend, it’s your body, and tell.
• A Time to Tell—A video for Boy Scout–age boys from 11 to 14 years old—the target group for most molesters. It stresses the three R’s of youth protection: Recognize, Resist, and Report.
• Youth Protection: Personal Safety Awareness—Developed for youth ages 13 through 20 in the coeducational Venturing program. It deals with issues pertinent to this age group.
Youth Protection training is available online at www.MyScouting.org. You can establish an account there using the member number you receive when you register. If you take the online training before
you receive a member number, be sure to return to MyScouting and enter your number for training record credit or forward a copy of the training certificate to your council.
The Boy Scouts of America has Youth Protection policies to protect youth, and these same policies help protect adult volunteers. These and other key policies are addressed in the training:
• Two-deep leadership is required on all outings.
• One-on-one contact between adults and youth members is prohibited.
• Privacy of youth is respected.
• Separate accommodations for adults and Scouts are required.
• Units are responsible to enforce Youth Protection policies.
*Available online at www.MyScouting.org.You can also read
